Provider Demographics
NPI:1902944127
Name:POWERS, NANCY LOUISA (RN, NP, DNSC)
Entity Type:Individual
Prefix:DR
First Name:NANCY
Middle Name:LOUISA
Last Name:POWERS
Suffix:
Gender:F
Credentials:RN, NP, DNSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 189
Mailing Address - Street 2:
Mailing Address - City:RHODODENDRON
Mailing Address - State:OR
Mailing Address - Zip Code:97049-0189
Mailing Address - Country:US
Mailing Address - Phone:503-228-3081
Mailing Address - Fax:
Practice Address - Street 1:5331 SW MACADAM AVENUE
Practice Address - Street 2:SUITE 397
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3813
Practice Address - Country:US
Practice Address - Phone:503-228-3081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2014-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR087006752N1 FNP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR087006752N1OtherSTATE LICENSE